Content area
Abstract
Purpose
To investigate the predictive role of rib-vertebral angle (RVA) measurements in early adolescent idiopathic scoliosis (AIS) girls with right thoracic curve during brace treatment.
Methods
Early AIS (premenarchal and Risser 0) girls who had undergone brace treatment and had been followed regularly were recruited to this study. According to the bracing outcome, they were divided into Group A (non-progressed) and Group B (curve worsened over six degrees or indicated for surgery).
Results
Totally 48 girls were included. There were 30 and 18 patients in Groups A and B, respectively. Ratio of curve progression was significantly higher in patients with initial RVA difference (RVAD) [greater than or equal to]20° versus <20°, or convex RVA (CRVA) [less than or equal to]68° versus >68°. From brace initiation to the latest follow-up, CRVA was found to be significantly higher in Group A versus Group B (P < 0.05), while RVAD was higher in Group B versus Group A (P < 0.05). Serial measurements revealed an increasing trend for RVAD (from 19 ± 10° to 29 ± 8°) yet a decreasing trend for CRVA (from 68 ± 6° to 60 ± 7°) in Group B, but both RVAD and CRVA were found to remain stable in Group A during the follow-up period. Association analyses showed that both RVAD [greater than or equal to]20° and CRVA [less than or equal to]68° at brace initiation and at each follow-up were significantly associated with curve progression.
Conclusions
The initial RVAD [greater than or equal to]20° and CRVA [less than or equal to]68° serve as valid factors in predicting the risk of curve progression during bracing in early AIS. Constant watch on RVAD and CRVA can help to more accurately predict the effectiveness of bracing in these patients.